Acarturk 2015.
Methods | Single‐blind, parallel group, open‐label RCT | |
Participants | Refugees with PTSD symptoms forced to leave Syria owing to the war that started in 2011; living in Kilis Refugee Camp. The camp is located at the border between Turkey and Syria. Refugees, in addition to displacement and lack of shelter, have been exposed to traumatic events such as torture, serious injury to self or loved ones, death of family members, husband at war, and arrested family members. This pilot RCT was conducted between April 2013 and July 2013 Age range: 19‐63 years Inclusion criteria: 18 years and older, PTSD symptoms (Impact of Event Scale‐Revised ‐ IES‐R score 33) Exclusion criteria: mental retardation, pregnant, using psychiatric medication |
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Interventions | Eye movement desensitisation and reprocessing (EMDR) intervention: 15 participants EMDR given in different phases, including history taking, case formulation, and treatment planning; EMDR explanation; trauma memory selection; desensitisation; reporting of current emotions, sensations, and cognitions; and instillation of positive cognition. The closure phase in focused on relaxation Wait list control group: 14 participants Wait‐list participants did not receive any psychological or pharmacological treatment. They were informed that at the end of the study, they could receive psychological help from the research team |
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Outcomes | IES‐R scores for the EMDR group and the wait list control group. Symptoms of depression as measured with the Beck Depression Inventory‐II (BDI‐II) | |
Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Quote: "For the allocation of participants to different treatment groups, a computer‐generated random number list was used. Participants were randomly assigned on a 1:1 basis to the EMDR or wait‐list group" |
Allocation concealment (selection bias) | Unclear risk | No information provided |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Quote: "The participants and the therapists were aware of the allocated arm" |
Blinding of outcome assessment (detection bias) All outcomes | Low risk | Quote: "The outcome assessors were kept blind to the allocation" |
Incomplete outcome data (attrition bias) All outcomes | Low risk | No one withdrew from the study |
Selective reporting (reporting bias) | Low risk | Rating scales listed in the "Methods" section were reported in the "Results" section (IER‐R and BDI‐II) |
Therapist qualification | Low risk | Trained psychologists |
Treatment fidelity | Low risk | Quote: "The supervisor personally observed a minimum of one session with each therapist (with the permission of the participant). The supervisor checked during live and normal one‐on‐one and group supervision sessions whether the therapists were complying with the 8 Phase EMDR standard protocol. Treatment fidelity was supported by the supervisor, who attended at least one session of each therapist" |
Therapist/investigator allegiance | High risk | Psychologists were trained at EMDR level I by the second trial author, who is an EMDR Institute‐accredited trainer. No further information provided |
Other bias | Unclear risk | Sponsorship bias cannot be ruled out |